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Autonomic function in children with type 1 diabetes mellitus
H Tanaka1, L Hyllienmark, O Thulesius
1Department of Paediatrics, Osaka Medical College, Japan.
Summary
Autonomic function in Type 1 diabetes is largely preserved in youth, with no significant vagal impairment. However, beat-to-beat blood pressure variation may be reduced, correlating with metabolic control.
Area of Science:
- Pediatric Endocrinology
- Autonomic Neuroscience
- Cardiovascular Physiology
Background:
- Type 1 diabetes mellitus (T1DM) can affect autonomic nervous system function.
- Autonomic dysfunction in T1DM is typically assessed using cardiovascular reflex tests.
- Limited data exists on autonomic function in asymptomatic children and young adults with T1DM.
Purpose of the Study:
- To investigate autonomic function in children and young adults with T1DM.
- To compare autonomic function between T1DM patients and healthy controls.
- To assess the correlation between autonomic function and metabolic control in T1DM.
Main Methods:
- Evaluated 58 T1DM patients (aged 7-22) and 74 healthy controls.
- Utilized power spectral analysis of blood pressure and heart rate.
- Performed deep breathing, Valsalva maneuver, and standing tests.
Main Results:
- No significant differences in Valsalva or deep breathing tests between groups.
- Heart rate variation was lower in T1DM patients, but spectral analysis showed no significant decrease.
- Beat-to-beat blood pressure fluctuation was significantly lower in T1DM patients and correlated with HbA1c.
Conclusions:
- Vagal nerve involvement in T1DM is uncommon in this age group.
- Beat-to-beat blood pressure variation is more likely to be affected in young T1DM patients.
- Autonomic function, particularly blood pressure variability, may be an early indicator of T1DM complications.